Individual
STEPHANIE RICKRODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
2150 ALT 19 STE A, PALM HARBOR, FL 34683-5363
(727) 773-2687
(277) 773-2742
Mailing address
2150 ALT 19 STE A, PALM HARBOR, FL 34683-5363
(727) 773-2687
(277) 773-2742
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT17636
FL
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017352000
—
FL
Enumeration date
04/27/2016
Last updated
05/29/2019
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